Platelet-rich fibrin in combination with mandibular or maxillary non-vascularized bone graft: a systematic review

Introduction
Autogenous non-vascularized bone graft (NVBG) is the gold standard for treating defects smaller than 6 cm. In the maxillofacial region, NVBG is useful to treat periodontal defects, congenital defects, ridge atrophy, sinus augmentation, etc. The addition of autogenous platelet-rich fibrin (PRF) was reported to improve clinical outcomes. However, no high-quality evidence was ever made regarding this treatment combination.

Objectives
To assess the evidence of adding PRF to autogenous NVBG in the mandibular and maxillary regions.

Material and methods
Literature searches were conducted in PubMed, EMBASE, ProQuest, Scopus, EBSCO­host, and Science Direct to identify randomized controlled trials comparing PRF combined with autogenous NVBG and autogenous NVBG alone. The main outcomes were quantitative bone regeneration measured as height, length, volume, percentage, or other possible quantitative outcomes.

Results
Five studies were included in this systematic review comparing PRF and autogenous NVBG to ANVBG alone, with a total of 130 patients with ridge resorption, periodontitis with furcation involvement, or alveolar cleft. Measurements of outcomes were displayed as gained width, vertical bone changes, and volumetric changes. Two studies presented significant differences in the tested group.

Conclusions
PRF may improve bone regeneration in combination with autogenous NVBG. Future studies need to investigate with a larger population, size of defects, and better outcome measurements.